Archive for April, 2018

Deloras Jones graduated from the Kaiser Foundation School of Nursing more than 50 years ago, but she vividly remembers the school’s philosophy of scientific training. In a medical profession long beset by gender inequalities, the program was progressive in teaching the female students “the science of medicine … as physicians were,” said Jones.

Among Kaiser Permanente’s many contributions to health care, it’s important to recognize a legacy of support and respect for nurses. One prime example: Deloras Jones’ alma mater. At the end of World War II, when the health plan opened to the public, qualified nurses were in short supply.

To address the shortage, the Kaiser Foundation established the Permanente School of Nursing (later the Kaiser Foundation School of Nursing) in 1947 to train more nurses. The accredited school graduated its first class in 1950 and offered tuition-free education and training for its first 7 years. California regulations changed in the 1960s, requiring the school to transition from a diploma program to a degree-granting 4-year college. Efforts to connect with one of the local colleges while maintaining an independent identity were unsuccessful, and the last class graduated in 1976.

Kaiser Foundation School of Nursing logo, 1963

During its existence, the school graduated 1,065 nurses and boasted numerous accomplishments. It trained a diverse pool of highly skilled nurses (it was the first in California to consistently recruit minority students), and student scores in State Board Examinations consistently ranked in the top 3 of all California programs, including university schools. Watch their stories in this short video.

The article is the fruit of a legacy project that was launched in 2016 to research, capture and record the history and voice of Kaiser Foundation School of Nursing alumni. What emerged from these early nursing pioneers were inspirational stories about their pride of being part of a new way to provide health care that prioritized prevention, health promotion, and wellness over conventional “sick care” models.

These alumni became Kaiser Permanente’s earliest nurse leaders, educators, and care advocates, advancing new models for integrated patient care. Many graduates pursued advanced degrees and were instrumental in defining expanded nursing roles, including the introduction of nurse practitioners in California.

Kaiser Permanente nurses contributed to make their mark in advancing the field through research, such as the 1999 study “Exploring Indicators of Telephone Nursing Quality” in the Journal of Nursing Care Quality. Telephone nursing was an early effort in what we now call “telemedicine,” and the study resulted in important understandings about the effectiveness of technology-mediated care.

The school was an experiment that had run its course, but it had also enriched the Kaiser Permanente philosophy with a respect and value for the nursing profession as an essential component of group-practice medicine. To the world, it demonstrated the enduring importance of Kaiser Permanente’s leadership in disruptive innovation — in particular, the role of the nurse executive — in reimagining care for future generations. It’s a mission that continues to this day.

Original photos of hundreds of U.S. navy ships in San Francisco Bay. A candid shot of Henry J. Kaiser, laughing while listening to a female accordionist. A color transparency of an unidentified “Rosie” with a cutting torch in front of the ship Haiti Victory before her launch in July 20, 1944.

These are only some of the images from a treasure trove of World War II photographs, many depicting scenes from the Kaiser Richmond shipyards, discovered last year by Fresno professor Dan Nadaner. The photos have not been seen since the mid-1940s.

Dan was donating the pictures to the curators from the Rosie the Riveter/World War II Home Front National Historical Park in Richmond, California, located on the former site of the Kaiser shipyards. He found these cartons while clearing out a storage locker, and wanted the photos to join others already on display at the visitor center.

The photos were taken by Dan’s father, Hugo Nadaner (1915–2009), a real estate developer, contractor, private airplane pilot, and Hollywood photographer. But during World War II, he turned his lens to marine vessels, working with the U.S. Navy to document construction, launch and shakedown cruises.

Hugo Nadaner’s trove of 4×5-inch negatives and photos include images of hundreds of U.S. navy ships. Many are copy photos (photos of other photos), but others are original shots from San Francisco Bay. Although few are identified, some ships and locations are obvious.

Hugo Nadaner (on right), circa 1940s (photo courtesy Dan Nadaner)

A cluster of photos reveal how neighboring industries prefabricated ship components for final assembly in the Kaiser yards. Among the Oakland subcontractors documented between June 24 and 26, 1943, were the Graham Ship Repair Company (foot of Washington St.), the Herrick Iron Works, and the Independent Iron Works. Other nearby factories included Berkeley’s Trailer Company of America and the Steel Tank & Pipe Company, as well as the California Steel Products Corporation in Richmond and the Pacific Coast Engineering Company in Alameda. One contractor documented was the Clyde W. Wood Company in Stockton (a deepwater port on the San Joaquin River), over 50 miles inland from the Richmond shipyards.

There are many photos from the Kaiser Richmond shipyards. One set shows the launching of the patrol frigate USS Tacoma from shipyard No. 4 on July 7, 1943. These include the happy sponsor, Mrs. A.R. Bergerson, and two young women, ready with a champagne bottle. Another photo catches three white-bloused singers, while a third is of Henry J. Kaiser finishing a celebratory meal — and is he really singing along with an accordion?

Kaiser shipyard workers are frozen in time. One unidentified Journeyman Maintenance Worker is pumping liquid into a battered bucket; a black welder and a black supervisor share a joke while inspecting an electric arc stinger; the tool control crew from Yard 3 shows home-front women in the trades.

Kaiser Permanente Heritage Resources is helping the National Park Service to process this collection. Thank you, Dan and Hugo Nadaner, for your contribution to documenting and sharing the World War II home front.

Recycling didn’t start with Earth Day in 1970 — a date that many consider to be the birth date of the modern environmental movement. Reuse of materials has been a practice for many years, especially during shortages of raw materials.

During World War II, the effort to build massive ships also created mountains of industrial trash. And while all resources were prioritized for winning the war against fascism, everyone was encouraged to step up to produce as efficiently as possible. At the Kaiser shipyards, that also meant recycling.

In 1944, the four Kaiser shipyards in Richmond, California, produced more than 11,000 gross tons of scrap steel and 78,000 pounds of non-ferrous metals, as well as 11,400 paint pails, 2,056 carbide drums, and large quantities of rubber scrap, wire rope reels, scrap burlap, rope, batteries, and battery plates.

Much of the material collected was recycled on site. “The idea is to waste nothing,” a writer explained in the Kaiser Richmond shipyard newspaper, Fore ‘n’ Aft. “Strongbacks (braces), clips, dogs, wedges, bolts, nuts, and the like are dropped down separate chutes into bins to be reclaimed in the shop.” The article pointed out that at the shipyards’ “Yard Three,” during the previous month, a crew of 137 salvage workers had reclaimed 14,800 feet of pipe, sold 318 tons of scrap pipe-ends, made 254,616 strongbacks and clips, and reclaimed over 176,000 bolts and nuts.

Fast forward to the present and Kaiser Permanente is continuing to stake out ambitious goals for recycling. In fact, the organization aims to recycle, reuse, or compost 100 percent of its non-hazardous waste by 2025.

Then, as now, recycling on a massive scale required hard work. At the wartime shipyards, scrap ferrous metals were collected for sending to steel mills for re-melting, but only about 10 percent were ready to go into the furnaces. The rest had to stop off at preparers for sorting and cleaning. And recycling didn’t stop at the water’s edge. The job of salvage even carried on to the high seas where the ships brought back scrap from the world’s battlefields. Aboard ship, cooking fats and tin cans were saved from the galley; flue dust from the boilers and fire boxes yielded strategic vanadium and lamp black; and sailors were encouraged to save every possible rope-end.

“Scramble and scrape to save scrap to scramble the enemy,” the Fore ‘n’ Aft article ends. “Don’t forget your part as a war worker handling vital materials is a big one. Make everything count so you can make more things that count. Try to imagine a price tag on every piece of scrap.”

Creating healthy communities by preserving natural resources — good advice then and now.

Harold Albert Hatch was the exception: He was an insurance agent who had a bright idea that helped change the course of American health care. He did this when he suggested an unorthodox reimbursement approach to a young physician, Sidney Garfield, sometime in 1934 — prepayment.

This novel approach to industrial health insurance kept Dr. Garfield’s practice afloat, and survives as one of the fundamental components of the Kaiser Permanente health plan. It inverts the conventional model of medical economics, favoring prevention over treatment.

Industrial Indemnity Exchange logo

Prepayment for health care was not a completely new concept — the Ross-Loos Medical Group adopted it in 1929 to cover 12,000 employees and their families in the City of Los Angeles’ Department of Water and Power. But the practice for on-the-job care was novel.

Dr. Garfield and his partner Dr. Gene Morris ran a clinic in Southern California’s remote Mojave Desert for the workers on the Colorado River Aqueduct Project. It was standard industrial medical care, which was voluntary for California employers beginning in 1911 (and mandatory in 1914) to keep employees healthy and on the job. Industrial Indemnity was the largest insurer on that project.

The process was straightforward: A worker gets hurt on the job, sees the doctor, and the doctor gets insurance reimbursement. Workers’ compensation insurance worked — until it didn’t.

The issue for Dr. Garfield was that insurance companies challenged full reimbursement for bills and were slow to pay those they accepted. Dr. Garfield also handled medical care not covered by the insurance, and the workers couldn’t afford to pay much.

Confronted with the lag in reimbursement for care, Dr. Garfield was at risk of losing his practice, and the workers were at risk of losing the local health care they liked. Dr. Morris packed his medical bag and left.

Here’s how Hatch came in to help. Industrial Indemnity Exchange began when several major contractors (including Henry J. Kaiser and Warren Bechtel) banded together to self-insure their industrial health care in 1921. By the end of 1942, Industrial Indemnity would grow to be California’s second-largest writer of compensation insurance. Henry Kaiser’s right-hand man, Alonzo B. Ordway, was tasked with running it, and in 1934, they hired Hatch as underwriter and policy strategist. Hatch had been an engineer who as a child had been partially physically impaired by tuberculosis of the bone.

Hatch befriended Dr. Garfield, and proposed the novel insurance idea — paying 17.5 percent of its workers’ compensation premium back to Dr. Garfield to care for job-related injuries. That was 5 cents a day guaranteed income from each worker. Dr. Garfield accepted. The two men then completed the prepayment equation by adding a voluntary nonindustrial health plan for the workers for another 5 cents a day.

Newspaper account of Harold Hatch fending off a carjacking, 1958

With Dr. Garfield’s practice financially viable, he hired more physicians and built temporary hospitals along the aqueduct’s route. When the construction project ended, Hatch and Ordway recommended Dr. Garfield as the perfect candidate to care for workers at the Grand Coulee Dam in Washington. There, from 1938-1940, Dr. Garfield expanded his model to include a prepaid plan for worker families as well.

Hatch continued to consult with Kaiser and Dr. Garfield until 1948, when he founded the Argonaut Insurance company, which by the time of his death in 1962 was the second largest writer of workers’ compensation insurance in California.

Thank you, Harold Hatch, for your pioneering role in the evolution of health care insurance.

When Henry J. Kaiser and Kaiser–Frazer Motors released their entry-level passenger car in 1950, its name was the subject of a national contest that raised money for cancer research. The winner? “Henry J.”

But historical interpretation is full of “what ifs,” and recent research has turned up a startling alternate set of names for this humble little car that took on the Big Three automakers. An interoffice memo from Edgar F. Kaiser, Henry’s oldest son, to his father and Gene Trefethen — a lifelong Kaiser right-hand-man and corporate executive — reveals a charming detail of this high-stakes branding challenge.

Henry Kaiser partnered with industry expert Joseph “Joe” Frazer in this automobile venture, and Joe knew a thing or two about sales. While the naming contest was going full bore, Edgar and Joe were trying to make sure that whatever name was selected would have some traction.

Almost two months before the announcement of the winning name, Edgar spent several hours with Joe Frazer reviewing the 2,500 names at the top of the list.

Joe’s preference for first choice?

“Mustang.”

Edgar goes on to tell his father, “At the moment I favor calling the car ‘Kaiser Mustang’ but I am not sure that it will last with me.”